PrEP IN THE WILD
Every year, more than 2,500 gay and bisexual men become infected with HIV. Trans women and other groups also carry a high burden of HIV infection. If you have the virus, you have it for life. You’ll need to take medication to keep you alive. You’ll need to be monitored by clinical services. HIV is no longer the death sentence it once was, but it is still a life sentence.
PrEP stands for PreExposure Prophylaxis, which means it’s a prevention that you take in advance. When taken correctly, PrEP HIV prevention than other methods – including condoms. On its own, PrEP wouldn’t reach enough people to end HIV, but combined with continued condom use, and an expansion of the success we’ve seen in getting people diagnosed earlier and treated, the end of HIV is at least in sight.
Without PrEP being available on the NHS, some gay men have taken it upon themselves to get their hands on the pills. A month’s supply of Truvada, the drug approved for PrEP, costs about £400, although cheaper generic versions are also available, at about 10% of that cost. It’s legal to import these drugs for personal use.
But unlike condoms, PrEP doesn’t prevent other STIs, which makes it even more important that anyone on PrEP gets checked regularly so that any other infections can be detected quickly, and treated. There’s a danger that by forcing people to access PrEP ‘in the wild’ those crucial links with sexual health services are severed, in itself contributing to poorer sexual health. Also, while the majority of people who take it can have an impact on your kidneys and bone density, which is why it’s vital that people on PrEP get monitored, in the same way as people taking the same drugs to treat HIV are monitored.
HIV prevention organisations and medical bodies – including GMFA, THT, NAT, NAM, LGBT Foundation, BHIVA and BASHH – are united in calling for PrEP to be made available. We don’t want everyone to be put on PrEP. However, there are a number of people – many of them gay men – who by their behaviour are clearly on the path to acquiring HIV.
In the era of chemsex, it has become even more of a challenge to change patterns of unsafe sexual behaviour. You can be a staunch advocate of condoms, but unless you have some magic wand, you’re not going to be able to convince everyone to use condoms all the time. The increasing prevention challenge is played out against a backdrop of diminishing funding for prevention, a pattern we’ve seen ever since the 80s.
PrEP isn’t a magic bullet, but combined with other prevention tools we could down to a level where we’d soon see it die out. To do this would require PrEP being greatest risk of acquiring HIV, and not just those who can savings on treatment and care for people living with
We have the tools we need to end HIV. Just imagine how great that would be. Then